BOARD DATE: 23 July 2014 DOCKET NUMBER: AR20140010501 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition. 2. The applicant states, in effect, the case file should be reviewed in accordance with the Secretary of Defense directive for a comprehensive review of members who were referred for a disability evaluation between 11 September 2001 and 30 April 2012 and whose mental health diagnosis was changed during that process. 3. The applicant submitted an application through the DOD Physical Disability Board of Review (PDBR) Mental Health Special Review Panel (SRP). CONSIDERATION OF EVIDENCE: 1. The PDBR SRP conducted a comprehensive review of the applicant’s submissions and records for evidence of inappropriate changes in the diagnosis of a mental health condition during processing through the military disability system. 2. The Department of Defense memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of mental health diagnoses for service members completing a disability evaluation process between 11 September 2001 and 30 April 2012 in order to determine if service members were disadvantaged by a changed diagnosis over the course of their physical disability process. 3. In the processing of this case, an advisory opinion was obtained from the PDBR SRP and the applicant was provided a copy. 4. The applicant did not respond to the advisory opinion. DISCUSSION AND CONCLUSIONS: 1. After a comprehensive review of the applicant’s case, the SRP determined by unanimous vote that there should be no change to the prior determination. 2. The SRP considered the appropriateness of changes (if any) in the MH diagnoses and provided remedial recommendations if it is judged that there were any elimination or unfavorable changes in MH diagnoses by the service. The SRP further considered whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 were applicable to any unfitting MH condition (physical evaluation board (PEB) adjudicated or SRP recommended), and made rating recommendations in accordance with VASRD Section 4.130 (and VASRD Section 4.129 as appropriate). 3. The SRP directed attention to its recommendations and its first assessment with regard to the MH condition, under MH Review guidelines, was to judge (based on a preponderance of evidence) whether an MH diagnosis was changed or unfairly eliminated during the Disability Evaluation System (DES) proceedings. The profile, narrative summary (NARSUM), the medical evaluation board (MEB) and PEBs all listed depression as the MH diagnosis. The MEB physical listed “History of ‘Post-Traumatic Stress Disorder (PTSD)’/adjustment disorder” under block 78 recommendations for further exams. Therefore, the applicant’s case did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 4. The SRP later deliberated whether the service MH diagnosis of depression was appropriate. In this case there were conflicting professional opinions on record, and contradictory evidence for the requisite Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) criteria. The applicant’s Post-Deployment Health Reassessment (PDHRA) responses regarding the absence of Criterion A stressors was considered a formidable detractor with respect to the probative value of subsequent subjective historical reports since the stressor questions are straightforward and unequivocal in the PDHRA format, and the responses were recorded shortly after deployment and before any secondary gain influence was operant. Although Criteria B (re-experiencing), C (avoidance), and D (hyperarousal) responses may evolve over time, the Criterion A (stressor) accounting is expected to be a static response. 5. The SRP noted the MEB psychiatric opinion was considered reasonable in that regard. The psychiatric presentation described in the VA Compensation and Pension (C&P) evaluation was also not congruent with the service treatment records evidence of an extended course of symptoms of anxiety and depression with a heavy overlay of external stressors. 6. After due deliberation, the SRP agreed that there was not a preponderance of evidence to support a recommendation for changing the MH diagnosis (depression, NOS) as adjudicated by the service. The SRP then turned to its assessment of the fairness of the PEB’s determination that the established MH condition (or any alternate MH condition) was not unfitting. The MEB psychiatric opinion, the commander’s opinion, the S2 profile, and the applicant’s concurrence with the overall PEB determination that he was fit for duty are strong arguments against a conclusion that there was an unfitting MH impairment. 7. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the MH condition. 8. The available evidence shows the SRP’s assessment should be accepted. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING __X______ __X______ _X____ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. _________X______________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ABCMR Record of Proceedings (cont) AR20040003532 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20140010501 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1